CCRN-Pediatric Exam Dumps - AACN CCRN Questions and Answers

In neonates and young infants,hypoventilationanddecreased level of consciousness (LOC)are late and critical signs ofdecompensationin systemic infection or shock. A progression from normal respiratory rate tohypoventilation, especially with altered LOC, indicatesimpending respiratory failure or septic shock.

“Hypoventilation and changes in mental status (such as lethargy or decreased LOC) are indicators of deterioration in infants with sepsis or dehydration. Immediate intervention is required to prevent arrest.”

(Referenced from CCRN Pediatric – Direct Care: Multisystem, Pediatric Sepsis and Deterioration Cues)

Children withSMA Type Ihave profound muscle weakness, including respiratory muscles. RSV increases respiratory workload, and once non-invasive measures and suctioning fail,intubation and mechanical ventilationare indicated to reduce fatigue and support gas exchange.

“Patients with neuromuscular disorders such as SMA are at increased risk for respiratory failure during acute infections. Mechanical ventilation is required when oxygenation does not improve with non-invasive methods or when respiratory fatigue is evident.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary Disorders and Neuromuscular Disease)

O₂ saturations in the low 90s despite 50% FiO₂ signal worsening gas exchange. Non-invasive support may be inadequate in the setting of hypotonia and viral pneumonia.

These are classic symptoms ofICU delirium, especially in pediatric or neurologically impaired patients. The nurse shouldmodel supportive, calm behavior,reorient the patient, andeducate familyabout what they are witnessing. This helpsde-escalate tensionand provides therapeutic support.

“In managing ICU delirium, the nurse should support the patient, reduce stimuli, and help families understand and cope with the patient’s altered mental status.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Delirium and Cognitive Dysfunction)

This statement reflectsemotional and existential distressrather than a purely educational need. Apalliative care consultis appropriate to provideholistic support,clarify goals of care, and ensure that the family's values and quality-of-life concerns are addressed within a multidisciplinary approach.

“Palliative care is appropriate when families face complex, life-altering decisions. It supports communication, decision-making, and emotional well-being alongside curative or life-sustaining treatments.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Palliative Care and Family-Centered Decision-Making)

It is a best practice—and often required by hospital policy—fortrained personnel such as an organ donation liaison or organ procurement organization (OPO)representative to approach families about organ donation. This ensures that the conversation is handled sensitively, accurately, and in accordance with regulatory requirements.

“The nurse should notify the designated organ donation liaison or team when a patient meets criteria for brain death. These individuals are trained to communicate effectively and ethically with families.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Ethics, End-of-Life Care, and Organ Donation)

This infant displays signs ofearly septic shock, includingtachycardia,fever,normal cap refill, andlow CVP. In thehyperdynamic early phase of septic shock, patients may initially havewarm, flushed skinandbounding pulses, with preserved perfusion before progressing to a decompensated state.

“Septic shock may present with increased HR, fever, and warm extremities in its compensated phase. CVP may be low due to vasodilation and capillary leakage.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Types of Shock and Sepsis Pathophysiology)

A sudden drop in oxygen saturation withdiminished breath sounds bilaterallysuggests a possibleET tube issue, pneumothorax, or mucus plug. Achest x-rayis the most appropriate immediate step toidentify the cause, and anABGcan assess ventilation status.

“Sudden desaturation in an intubated patient warrants immediate imaging and gas exchange assessment to identify pneumothorax, malpositioned tube, or obstruction.”

(Referenced from CCRN Pediatric – Direct Care: Pulmonary, Emergency Airway Complications)

Post-coarctectomy syndromeis a complication seen after surgical correction ofcoarctation of the aorta, especially in older children. After repair,sudden restoration of high blood flow to the mesenteric arteries(after years of reduced perfusion) can cause:

Abdominal pain

GI bleeding

Bowel ischemia

“Post-coarctectomy syndrome involves mesenteric vasculature injury due to abrupt restoration of high-pressure flow after chronic hypoperfusion.”

(Referenced from CCRN Pediatric – Direct Care: Cardiovascular, Postoperative Complications of Congenital Heart Repair)

When ethical dilemmas arise and thefamily is conflicted despite medical consensus, the institutional ethics committee should be involved to guide decision-making through astructured, neutral process.

“When disagreement persists about life-sustaining treatment, referral to the institutional ethics committee is recommended to facilitate discussion, evaluate values, and support consensus-building among the care team and family.”

(Referenced from CCRN Pediatric – Professional Caring and Ethical Practice: Ethical Decision-Making and End-of-Life Care)

While palliative care supports symptom relief, theethics committee is the appropriate avenue for addressing decisional conflictregarding the care plan.

Febrile seizuresare the mostcommon cause of seizures in infants and young children, typically between 6 months and 5 years. They often occur with arapid rise in body temperature, even inthe absence of intracranial infection or metabolic disturbances.

“In infants, febrile seizures are the most likely cause of new-onset seizures. Tonic-clonic activity confined to extremities is typical. Evaluation focuses on identifying the febrile source.”

(Referenced from CCRN Pediatric – Direct Care: Neurological, Pediatric Seizure Disorders)

Lead poisoning and structural brain anomalies are less common and usually not the first consideration in an acute setting with fever.